Heller myotomy and laparoscopic fundoplication in achalasia. A retrospective experience

Cir Cir. 2012 Jan-Feb;80(1):38-43.

Abstract

Background: Laparoscopic myotomy associated with fundoplication is a useful therapeutic resource for the treatment of achalasia. The aim of the study was to analyze the outcomes of the surgical treatment of achalasia in a group of patients treated at the Hospital Naval de la Secretaría de Marina and at the Hospital Español in Veracruz during a 6-year period.

Methods: Eleven patients were submitted to myotomy and fundoplication. Variables analyzed were age, gender, symptom duration, surgical complications, surgical time, day/stay, and postoperative morbidity.

Results: Mean age was 41.7 years ± 7.69 years; 63.64% of the patients were male and 36.36% were female. Average time from symptom onset was 2.5 ± 1.38 years. All patients had received previous unsuccessful medical and endoscopic treatment. Diagnosis was confirmed by esophagogram, endoscopy and manometry. All patients underwent Heller myotomy and fundoplication. Operative time was 140.4 ± 26.2 min. Average days/stay was 3.7 ± 1.4 days. Postoperative course was satisfactory in all patients and there was no perioperative mortality. Average follow-up was 3.8 ± 2.3 years.

Conclusions: In our group, laparoscopic myotomy with fundoplication was a safe procedure offering excellent results comparable with those published in the literature. There is controversy about the type of fundoplication; therefore, the choice is at the discretion of the surgeon.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Esophageal Achalasia / diagnostic imaging
  • Esophageal Achalasia / surgery*
  • Esophageal Sphincter, Lower / surgery*
  • Esophagoscopy
  • Female
  • Fundoplication / methods*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Manometry
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Radiography
  • Retrospective Studies
  • Treatment Outcome